Individual
NISHA PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
3880 SALEM LAKE DR STE F, LONG GROVE, IL 60047-5292
(847) 719-2220
(847) 719-2265
Mailing address
3880 SALEM LAKE DR STE F, LONG GROVE, IL 60047-5292
(847) 719-2220
(847) 719-2265
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209015600
IL
363LF0000X
Family Nurse Practitioner
209015600
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209015600
—
IL
Enumeration date
02/10/2017
Last updated
03/07/2023
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